Amid the backdrop of national health care reform, more than 52,000 Imperial County residents are set to undergo unrelated changes in how their Medi-Cal benefits are managed.
The county Board of Supervisors decided to transition into Medi-Cal managed care Tuesday. Medi-Cal managed care is a state-mandated organizational system best described as a community of local independent health care providers who work together to manage Medi-Cal patients’ care.
The county currently operates under a “Fee for Service Medi-Cal,” meaning Medi-Cal patients are mostly on their own to find doctors or clinics that take Medi-Cal.
But the county had three options of Medi-Cal managed care.
Supervisors decided that the best option was the so-called “Two-Plan model,” which includes a county-developed public plan, and a single commercial plan.
Under the Two Plan model, Medi-Cal beneficiaries have the ability to choose between the county-developed public plan and the commercial plan, said Imperial County Public Health Director Robin Hodgkin during her presentation to the board.
The Two Plan model “allows us to create a health plan that will have some of the capabilities that we feel we’ll need, some of the ability to address some of the health issues in Imperial County … such as diabetes, asthma and create unique programs that will better serve our population,” she said.
Once implemented, the public plan, also referred to as the “Local Initiative,” will work side-by-side with a commercial plan that will be selected by the state through a procurement process, Hodgkin added.
Earlier, she explained there was the possibility of pursuing a so-called County Organized Health System, which creates a single local plan to cover Medi-Cal beneficiaries.
However, this plan would require a federal waiver, since it doesn’t provide options to beneficiaries.
The other plan available was Geographic Managed Care, which allows multiple commercial health plans from private companies to operate in a county.
But local control has been the county’s priority, according to a report to the board. Consequently, the county dismissed Geographic Managed Care.
The transition, expected to take several months, doesn’t affect Medi-Cal eligibility, it affects the delivery of services.
This major transition takes place as health care reform continues, which in Imperial County is expected to make about 20,000 more people eligible for Medi-Cal.
Meanwhile, with more than 52,000 eligible residents, the county already has one of the highest rates of Medi-Cal-eligible beneficiaries per capita in the state.
And though studies show that costs go down when you organize a system of health care delivery, the county still faces a shortage of doctors.
Meeting glance
Here are four things that happened in Tuesday’s meeting
1 - Sequester-mandated furloughs in the Department of Homeland Security are set for April 1, said Supervisor John Renison and noted border wait times are expected to be impacted.
2 - The second-ranking Democrat on the Homeland Security Committee, Congresswoman Loretta Sanchez, will visit the county April 29, Supervisor John Renison announced.
3 - Supervisors accepted more than $1 million to improve the Wiest Lake boat launching facility. The money comes from the California Boating and Waterways Commission.
4 - The Joint Strike Fighter Coalition is set to meet Wednesday to prepare for Thursday’s public hearing in El Centro on the draft environmental impact statement, Supervisor Jack Terrazas said. Supporters advocate that the Navy’s F35C Joint Strike Fighter squadron at NAF El Centro would bring much-needed economic benefits to the area. The hearing will take place at Southwest High School, at 5 p.m.
Staff Writer Alejandro Dávila can be reached at 760-337-3445 or adavila@ivpressonline.com
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